Individual
AMY MAE IVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 BAYBERRY LN, LONDONDERRY, NH 03053-4604
(978) 856-5789
Mailing address
117 BAYBERRY LN, LONDONDERRY, NH 03053-4604
(978) 856-5789
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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